31C-015 (11) 0
City of Northampton
/ Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS `� D
1 212 Main Street • Municipal Building �t — !i
3 Northampton, MA 01060 bpjS`4�
31C C) OCT 1 0 2019
TENT PERMIT APPLICATION DEPT OF BUILDING INSPECTIONS
I NORTHAMPTON,MA 01060
(For Tents over 120 square feet)��// „
Permit Fee: $30.00 Check# 6?64
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Smith College Richard Korzeniowski
Address: 126 West Street —Telephone:,_ (413) 585-2458
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): Field House- 137 West Street
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5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: 1-20'x 20'Tent
Occupant Capacity:
Dates of Use: Saturday, October 19th,.2019
Inspection Friday, October 18th, 2019. After 12:00 (Noon)
7. ALL INFORMATION MUST BE COMPLETED:PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
8. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: -1-2011Q APPLICANT'S'SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.